Provider Demographics
NPI:1053777011
Name:COLIBRI, JULIE ANNE (MSW)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ANNE
Last Name:COLIBRI
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1690 MILWAUKEE WAY APT 205
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-3028
Mailing Address - Country:US
Mailing Address - Phone:360-280-7593
Mailing Address - Fax:
Practice Address - Street 1:1690 MILWAUKEE WAY APT 205
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-3028
Practice Address - Country:US
Practice Address - Phone:360-280-7593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-06
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCSW-LIC-665471041C0700X
WALW614333691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical